Chuukese migrant women in guam Perceptions of barriers to health care

A descriptive qualitative study examined perceived barriers to health care among Chuukese migrant women in Guam and the factors that influenced health-seeking behaviors. Since the Compact of Free Association with the United States was enacted in 1985, there has been a dramatic rise in the numbers of Chuukese migrating to Guam. This migration is anticipated to continue, with more migrants needing health care, education, and social services. Little is known about their perceptions of barriers to health care services or the factors that influence their health-seeking behaviors. Focus groups and key informant interviews provided rich data, which were analyzed using content analysis. Themes revealed included: (a) barriers to seeking and maintaining health; (b) social and cultural factors influence health-seeking behaviors; and (c) political influences affecting migrants. Major barriers identified were financial issues, difficulty in obtaining care due to long wait times, transportation problems, and struggles with language and cultural nuances of communication. The women relayed a mistrust of health and social services resulting from communication barriers. The literature supported the findings related to barriers and mistrust exacerbated by linguistic and cultural barriers. Social and cultural factors included the use of traditional Chuukese medicines, lack of preventive care services, Chuukese gender norms, the role of women, and confidentiality concerns. The finding of confidentiality concerns was unique to this research study. Key informants reported immense educational barriers that influenced the health-seeking and health maintaining behaviors of the Chuukese migrants. Qualitative research studies on Micronesian migrants in the United States supported the themes of educational needs and lack of preventive care. Participants gave recommendations to improve care for Chuukese migrant women in Guam. There was a call to action from participants and a strong desire to achieve the mutual goal of improved care for Chuukese migrants in Guam.